OBJECTIVE To examine the association between the combination of central and general obesity measures and the risk of pelvic organ prolapse (POP). METHODS Waist/height ratio and body mass index (BMI, calculated as weight in kilograms divided by height in meters squared) for 251,143 participants (aged 39-71 years) without pre-existing POP from the UK Biobank were collected at enrollment between 2006 and 2010. Participants were followed through December 19, 2022. Incident POP was identified using International Classification of Diseases, Tenth Revision codes and operating procedure codes in the medical records. Cox proportional hazards model was used to estimate the association between obesity measures and incident POP. Population-attributable fractions were calculated to indicate the proportion of cases that were attributable to obesity measures. RESULTS During a median follow-up of 13.8 years, 9,781 POP cases were recorded. Central obesity (waist/height ratio 0.5 or greater) was associated with a 48% increased risk of POP regardless of BMI (hazard ratio [HR] 1.48; 95% CI, 1.41-1.56). Approximately 21.7% (95% CI, 19.1-24.4%) of all POP cases were attributable to central obesity. In addition, overweight without central obesity (BMI 25-29.9 and waist/height ratio less than 0.5) was associated with a 23% higher risk of POP (HR 1.23; 95% CI, 1.14-1.34), and this accounted for 2.0% (95% CI, 1.1-2.9%) of all POP cases. The magnitude of increased POP risk associated with central obesity varied by age (younger than 60 years vs 60 years or older: 57% vs 39%) and by history of hysterectomy (no vs yes: 54% vs 27%). CONCLUSION Central obesity and overweight without central obesity are risk factors for POP.

中文翻译：

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中枢性和全身性肥胖指标与盆腔器官脱垂的关联。


目的 探讨中心性肥胖和全身肥胖指标联合与盆腔器官脱垂 （POP） 风险之间的关联。方法 在 2006 年至 2010 年期间，收集了 251,143 名参与者（年龄 39-71 岁）的腰高比和体重指数（BMI，计算为体重（公斤）除以身高（米）的平方）。参与者被跟踪至 2022 年 12 月 19 日。使用病历中的国际疾病分类、第十修订版代码和操作程序代码确定事件 POP。Cox 比例风险模型用于估计肥胖测量与事件 POP 之间的关联。计算人群归因分数以表明可归因于肥胖测量的病例比例。结果 在中位随访 13.8 年期间，记录了 9,781 例 POP 病例。无论 BMI 如何，中心性肥胖 （腰/高比 0.5 或更高） 都与 POP 风险增加 48% 相关 （风险比 [HR] 1.48;95% CI，1.41-1.56）。大约 21.7% （95% CI，19.1-24.4%） 的 POP 病例归因于向心性肥胖。此外，无中心性肥胖的超重 （BMI 25-29.9 且腰高比小于 0.5） 与 POP 风险增加 23% 相关 （HR 1.23;95% CI，1.14-1.34），占所有 POP 病例的 2.0% （95% CI，1.1-2.9%）。与中心性肥胖相关的 POP 风险增加的程度因年龄（小于 60 岁 vs 60 岁或以上：57% 对 39%）和子宫切除术史（否 vs 是：54% 对 27%）而异。结论 向心性肥胖和无向心性肥胖的超重是 POP 的危险因素。